| NPI | 1134177256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM S STIBICH Owner Provider Physician 501-623-7609 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2021-09-08 |